The view from inside major medical centers
SALEM: One other piece that really comes to into play when you talk about big federal dollars in that is the pharmaceutical aspect relative – you know, we – academic medical centers, aren't purchasing from Rouche the doses of Tamiflu, nor are we funding the large paramedical production of the vaccine relative to H5N1 bird flu. And that's where a huge amount of dollars are going.
KELLY: Yes, Frank.
PEACOCK: I have sort of a carrot and a stick and the good news, I think, is that the surveillance system seems to be getting put in place and that seems to actually work, where at the local level we have labs that are testing for flu and when have they have a positive they report it up the chain on command to the Ohio Department of Health. We have doctors scattered throughout the community that when they see someone with an influenza-like illness, they report that. And then we have autopsy reports. All that stuff then is reported up to the Ohio Department of Health; that then in turn is reported regional, which is then reported nationally.
Now I know the Ohio system well, I don't know all states, but I'm making the assumption that works across the nation because the CDC ultimately ends up with that data. That's good. That way we can track the flu – we know when we have to do something.
I think the other difficult part of this is, and you'll – a little bit with the military, is what I call the transportation issue. Now, you wouldn't transport people around for a pandemic but for a disaster, you know, during Katrina I got all these phone calls even single day, let's go down there, let's set up a hospital down there, and my response is, they're under 10 feet of water. Why do I want to go try to put a hospital in 10 feet of water? I've got a perfectly, functioning, dry hospital right here – bring them to me. That system doesn't really seem to work. And if San Francisco gets hit or if, you know, there's a disaster in Chicago where they are locally overwhelmed, Cleveland's going to be fine – bring me those people. And we have the NDMS – the Natural Disaster Management System – but I'm not convinced that we have a way to get 2,000 people from Chicago to Cleveland but I got the beds for them. We cancelled – in September 11th we cancelled elective surgeries in two days. We got a whole hospital that can take people but somehow we have to have interstate transfer of sick people when the local area is overwhelmed.
KELLY: Vicki, in your experience, I mean, do you know who to coordinate with in the federal government? Do you feel confident that the right people are going to be there when you need them?
RUNNING: Yes and no to that answer. I do believe that the federal government is trying their best to help the healthcare industry to mitigate a potential disaster that hasn't happened yet. And because it hasn't happened yet, unlike Katrina, we don't know exactly the nature of that disaster, so our planning has to be on a broad basis even though we realize there are two different types of events, one that impacts infrastructure like Katrina and other events that are disease related.
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